Provider Demographics
NPI:1851869861
Name:STANDSTRONG LLC
Entity Type:Organization
Organization Name:STANDSTRONG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:EDGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-206-6240
Mailing Address - Street 1:522 N CENTRAL AVE UNIT 679
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85001-2631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:430 N DOBSON RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5276
Practice Address - Country:US
Practice Address - Phone:480-565-2276
Practice Address - Fax:602-532-7839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty